Antihypertensive drugs reduced pulse wave velocity, with ACE inhibitors and ARBs showing greater efficacy, while beta-blockers were inferior to other classes in reducing augmentation index.
Do various antihypertensive drugs reduce arterial stiffness and wave reflections compared to placebo or other antihypertensive classes?
ACE inhibitors and ARBs appear superior for reducing arterial stiffness, while beta-blockers are inferior for reducing wave reflections, though the clinical relevance for cardiovascular events remains unclear.
We reviewed trials that tested the efficacy of antihypertensive drugs in reducing arterial stiffness and wave reflections as assessed by pulse wave velocity and augmentation index, respectively. Regardless of cross-over or parallel-group comparison design, placebo-controlled trials demonstrated that antihypertensive drugs were effective in reducing pulse wave velocity. In actively-controlled parallel-group comparison studies, this effect on arterial stiffness was more evident for angiotensin-converting enzyme inhibitors or angiotensin receptor blockers than other classes of antihypertensive drugs, particularly when brachial-ankle pulse wave velocity was measured. Regardless of cross-over or parallel-group comparison or placebo- or actively-controlled design, the reviewed trials showed that β-blockers were inferior to all the other classes of antihypertensive drugs in reducing augmentation index. However, these studies had a small sample size and a short follow-up time and did not link the changes in measurements of arterial function with cardiovascular events. Whether the superiority or inferiority is clinically relevant for cardiovascular protection and prevention remains to be investigated.
Liu et al. (Tue,) conducted a review in Arterial stiffness and wave reflections. Antihypertensive drugs vs. Placebo or other antihypertensive drugs was evaluated on Arterial stiffness and wave reflections (pulse wave velocity and augmentation index). Antihypertensive drugs reduced pulse wave velocity, with ACE inhibitors and ARBs showing greater efficacy, while beta-blockers were inferior to other classes in reducing augmentation index.